What Is Postmenopause?
Hormone fluctuations are a consistent part of life for women. From the onset of puberty, when hormones are raging, to menopause, when hormones gradually diminish, fluctuating hormones generally produce challenging symptoms.
Women experience the menopause transition in three stages that progress with a gradual decrease in the hormones estrogen, progesterone, and testosterone.
Perimenopause
Perimenopause means “around menopause,” and it’s the first stage of the menopause transition. It lasts approximately eight to ten years, and the cardinal menopause symptoms like hot flashes and mood swings begin to manifest at this time. Hormone levels fluctuate, but women can still get pregnant in perimenopause; even with the inconsistency of periods, menstruation has yet to cease completely. During this stage, women can begin hormone replacement therapy (HRT) to replenish hormones and improve their experience with symptoms.
Menopause
Menopauseoccurs naturally around the ages of 45-50. There is a deficit of estrogen, and the ovaries stop releasing eggs, marking the end of the reproductive years. Menopause is specifically defined as going 12 consecutive months without a period. Many women experience hot flashes, night sweats, and other symptoms during this time.
Postmenopause
Postmenopause is identified as the time after a woman has crossed the threshold of menopause. The symptoms associated with menopause can subside and disappear altogether during this stage, but they can also endure for as much as a decade beyond menopause.
These three stages are differentiated by levels of estrogen and progesterone and the length of time a woman goes without these reproductive hormones. With hormones absent, postmenopause can present challenges and health risks. But solutions are available to manage symptoms and risks, including bioidentical HRT, medication, and healthy lifestyle choices.
Symptoms of Postmenopause
Once menstruation finishes and menopause is officially complete, a woman may still have persisting symptoms. Vasomotor symptoms, which constitute hot flashes and night sweats, affect at least 75% of menopausal women, and they can last for as many as 10 years into postmenopause. In addition to hot flashes and night sweats, the following are the other most common lingering postmenopausal symptoms:
Mood changes: estrogen plays a role in the production of serotonin, a mood-regulating transmitter. Fluctuating hormones can disrupt serotonin, causing mood swings.
Depression: the disruption of serotonin and neurotransmitters can go beyond mood and result in challenges with mental health.
Insomnia: mood changes, vasomotor symptoms, and other factors can lead to trouble falling asleep and/or a lack of restful sleep.
Fatigue: insomnia, sleep disruptions from night sweats, and menopausal sleep apnea can inhibit restful and restorative sleep, causing long-term fatigue.
Weight gain: estrogen and progesterone disruptions increase susceptibility to weight gain, especially abdominal fat deposits.
Hair loss: lack of estrogen can cause female pattern hair loss or thinning, due to follicles shrinking and hair growing more slowly.
Vaginal dryness: diminished estrogen makes vaginal tissue thinner and more dry, compromising the effectiveness of the body’s natural self-lubrication.
Painful sex: dry vaginal tissue and insufficient lubrication can make intercourse painful.
Urinary incontinence: the urinary tract becomes more sensitive to the lack of estrogen, causing frequency, urgency, and some incontinence.
Health Risks Associated with Postmenopause
After women enter the postmenopausal phase, they may also develop any number of age-related conditions or diseases:
Cardiovascular disease - estrogen helps control cholesterol levels, and it has a protective mechanism for the arteries in the heart. After menopause, when estrogen is absent, the risk of fatty plaques in the arteries increases, contributing to blockages and heart attacks and increasing the chances of stroke.
Diabetes - the loss of estrogen decreases the ability of the body to process sugar and insulin efficiently. Lack of sleep during postmenopause can also affect optimal blood-sugar control.
Metabolic Syndrome - this is the combination of three or more of the following indicators: high blood sugar, high blood pressure, increased triglycerides, low levels of High-Density Lipoprotein (good cholesterol), and large waist circumference.
Osteoporosis - 50% of postmenopausal women will have osteoporosis and risk a broken bone. Menopause accelerates bone loss and increases the risk of osteoporosis. Estrogen helps slow the natural breakdown of bone.
Renal Issues - kidney disease may emerge as a result of high blood pressure and diabetes, affecting kidney function; both can occur with the loss of reproductive hormones.
Sexual dysfunction - decreased interest in sex and painful sex can occur in postmenopause.
Sleep apnea - this is a disorder in which breathing stops and starts during sleep, and resulting oxygen deprivation may cause a person to awaken several times throughout the night. Progesterone and estrogen help reduce a woman’s risk for developing this disorder.
Postmenopause Treatment
It’s integral to consider overall health and well-being during the entire menopause transition and throughout postmenopause. Embracing a healthy lifestyle that includes regular exercise, intentional eating, and the addition of HRT, (if appropriate), can help women stay healthy, fit, and revitalized.
Exercise: Just 30 minutes of moderate, aerobic activity five times a week can make a big difference. Walking can relieve stress and maintain both muscle mass and a stable weight. Strength training with weights or resistance training is also important for maintaining/increasing muscle mass and a healthy weight, as well as preserving bone health. Yoga, which is helpful for balance and relaxation, can also contribute to overall well-being.
Nutritious diet: Eating plenty of fruits, vegetables, and fiber-rich foods; avoiding processed foods and added sugars; and limiting alcohol and caffeine can all help support health and longevity. Foods high in calcium and vitamin D can help mitigate bone loss. Studies also show that eating more protein is necessary for menopausal women to maintain muscle mass, strength, and a healthy weight.
BHRT: Bioidentical hormone replacement therapy, to include estrogen, progesterone, and DHEA, renews and enhances a woman’s health during the entire menopause transition. HRT has comprehensive benefits for symptom improvement and preventive care. This includes combating osteoporosis and decreasing the risk of fractures. The Women’s Health Initiative studies showed a 34% reduction in hip fractures in women taking HRT. Estrogen also has a protective effect on cardiovascular health, decreasing the risk of heart attacks and strokes. Vaginal estrogen cream is a topical application that reduces urinary symptoms like frequency and urgency and keeps vaginal tissues hydrated and elastic.
Other medications: Certain antidepressants like Selective Serotonin Reuptake Inhibitors (SSRIs) can also be effective against hot flashes. In one study, hot flashes decreased by 62% with antidepressant use. Studies reveal that these medications could reduce the severity and frequency of vasomotor symptoms by up to 64%.
Conclusion
Women do not have to suffer needlessly as they progress through the menopause transition. Menopause is a natural part of a woman’s life, but when symptoms interfere with quality of life, they should not go unaddressed. Integrating positive habits and exploring HRT options are steps toward taking control of your health and feeling revitalized during the postmenopausal phase. The board-certified doctors at Winona are ready to discuss your symptoms and help you architect a personalized treatment plan.
